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Cravings and Pregnancy Are a Natural Combination

December 14, 2007

By the seventh month of pregnancy, the unborn baby is responsive to the tastes of different ingested substances. Unfortunately, there isn't much of a menu, but we won't go into that. The prospective mother, on the other hand, can hop into a car and ride out to obtain whatever taste her heart desires. Or better yet, send her husband, who will gain weight along with his wife during her pregnancy, but probably won't lose it afterward like she will. The prospective father enjoys his wife's cravings, too, because suddenly there is gustatory anarchy at the hands of runaway hormones. Men don't balk when they see the double-stuff Oreos arrive with the rest of the groceries.

Taste is very closely related to smell, using many of the same nerves and areas of the brain. The taste buds on the tongue are more richly vascular in pregnancy, changing the taste of many things for the pregnant woman. Suddenly Dr. Pepper of all things tastes pretty good. This vascular effect is evident in everything in pregnancy, from the gums of the mouth that bleed so easily with teeth-brushing to the spurt of growth of skin tags and moles that have better blood supplies around which to flourish. The estrogen of pregnancy is a great stimulant to blood vessel development and nutrition to all tissue, be it nasal mucosa, taste buds, or even cancer.

Pregnancy Cravings

Cravings are a natural part of pregnancy, with a complex set of factors contributing to the need to wolf down the hankering du jour. Sugar metabolism is altered, causing the insulin that's made to be less potent. Fat is stored at a different rate; protein is metabolized differently. Thyroid hormone, very closely related to the pregnancy hormone on a molecular level, affects appetite. The need for vitamins is increased, influencing a woman's desire to consume a particular food choice. A natural nurturing instinct causes her to choose portions of some items in varying proportions to what she usually chose before pregnancy. Salt metabolism changes, affecting thirst. There are I'm sure a host of yet to be discovered influences on why a woman craves certain things while pregnant. And of course there are the richly supplied taste buds. In my practice, I tend to be fairly forgiving of mild diet fluctuations. The overall nutritional picture must be balanced, of course, and the requirements of necessary items be satisfied, but for the most part weight gain is over-maligned. In fact, recent reports have indicated that the traditional recommendation of gaining 22 to 27 pounds may be unfairly limiting to the woman who may gain five or so more pounds than this. When it comes right down to it, each maternal-fetal unit is unique, and there is no formula that will fit everyone.

We know that there needs to be a diet adequate in calories, protein, essential fatty acids, minerals, and vitamins, but we also have to tolerate the occasional cravings that cumulatively may add only a few more pounds. Perhaps some humoral, endocrine, metabolic need is driving the woman to get something she needs, even if it's coming in the form of french fries. And let's not forget Mexican food. (After all, what are the women of Mexico supposed to eat?) But anything that's not in moderation can have bad effects. If crave-binging becomes the sole diet, modern prenatal care will have to step in. But most women do extremely well, and I feel the occasional craving makes life a little more tolerable to the pregnant patient during a time that can be physically and emotionally stressful.

The Top Ten Pregnancy Cravings

And now, the moment everyone's been waiting for The Top Ten Cravings During Pregnancy in My Obstetrical Practice:

Pickles at the deli counter at Winn-Dixie

City Park hot dogs (chili mandatory)

Anything from Baskin-Robbins (except the non-fat stuff)

Shoney's breakfast bar

Manuel's hot tamales

Sal & Judy's meatballs and spaghetti

Popcorn

Anything left in any family member's plate (many women choosing to over-serve each member at meal time)